Method for evaluating and comparing immunorepertoires

ABSTRACT

Disclosed is a method for amplifying RNA and/or DNA from immune cell populations and using the amplified products to produce an immune response profile and evaluate the possible correlation between a normal or abnormal immune response and the development of a disease such as an autoimmune disease, cancer, diabetes, or heart disease.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority of U.S. provisional patent application No. 61/045,586, filed Apr. 16, 2008.

FIELD OF THE INVENTION

The invention relates to methods for identifying biomarkers and to methods for identifying T-cell receptor, antibody, and MHC rearrangements in a population of cells.

BACKGROUND OF THE INVENTION

Scientists have known for a number of years that certain diseases are associated with particular genes or genetic mutations. Genetic causation, however, accounts for only a portion of the diseases diagnosed in humans. Many diseases appear to be linked in some way to the immune system's response to infectious and environmental agents, but how the immune system plays a role in diseases such as cancer, Alzheimer's, costochondritis, fibromyalgia, lupus, and other diseases is still being determined.

The human genome comprises a total number of 567-588 Ig (immunoglobulin) and TR (T cell receptor) genes (339-354 Ig and 228-234 TR) per haploid genome, localized in the 7 major loci. They comprise 405-418 V, 32 D, 105-109 J and 25-29 C genes. The number of functional Ig and TR genes is 321-353 per haploid genome. They comprise 187-216 V, 28 D, 86-88 J and 20-21 C genes (http://imgt.cines.fr). Through rearrangement of these genes, it has been estimated that approximately 2.5×10⁷ possible antibodies or T cell receptors can be generated.

Although, at the germine level, human beings are capable of generating large numbers of diverse Igs and TRs, the number of available Igs and TRs for a particular individual is actually much smaller due to negative selection during B and T cell development. In some individuals, this process may not remove some of the cells that would cross-react with the body's own tissues, and this may be the cause of some types of autoimmune diseases.

A few diseases to date have been associated with the body's reaction to a common antigen (Prinz, J. et al., Eur. J. Immunol. (1999) 29(10): 3360-3368, “Selection of Conserved TCR VDJ Rearrangements in Chronic Psoriatic Plaques Indicates a Common Antigen in Psoriasis Vulgaris”) and/or to specific VDJ rearrangements (Tamaru, J. et al., Blood (1994) 84(3): 708-715, “Hodgkin's Disease with a B-cell Phenotype Often Shows a VDJ Rearrangement and Somatic Mutations in the V_(H) Genes”). What is needed is a better method for evaluating changes in human immune response cells and associating those changes with specific diseases.

SUMMARY OF THE INVENTION

The invention relates to a method for producing an immune status profile (ISP) for a human and/or animal. In one aspect of the invention, the method comprises the steps of amplifying, in a first amplification reaction using target-specific primers, at least one RNA and/or DNA from a sample of white blood cells from at least one human or animal subject to produce at least one amplicon, at least a portion of the target-specific primers comprising additional nucleotides to incorporate into a resulting amplicon a binding site for a common primer; rescuing the at least one amplicon from the first amplification reaction; amplifying, by the addition of common primers in a second amplification reaction, the amplicons of the first amplification reaction having at least one binding site for a common primer; and sequencing the amplicons of the second amplification reaction to identify and quantify DNA sequences representing antibody and/or receptor rearrangements to create an immune status profile.

In another aspect of the invention, the step of rescuing the at least one amplicon from the first amplification reaction may be omitted, and the first and second amplification reactions may occur without separation of the amplicons from the target-specific primers. Genomic DNA may also be amplified, and the step of amplifying DNA may be substituted for the step of amplifying RNA, especially in cases where analysis of an immune system component such as the major histocompatibility complex (MHC) is desired.

In aspects of the invention, subpopulations of white blood cells may be isolated by flow cytometry to separate naïve B cells, mature B cells, memory B cells, naïve T cells, mature T cells, and memory T cells. In various aspects of the method, recombinations in the subpopulation of cells are rearrangements of B-cell immunoglobulin heavy chain (IgH), kappa and/or lambda light chains (IgK, IgL), T-cell receptor Beta, Gamma, Delta, and/or Major Histocompatibility Complex (MHC) molecules I or II.

In another aspect of the invention, the method may also comprise compiling and comparing the immune cell profile for a population of normal individuals with the immune cell profile for a population of individuals who have been diagnosed with a disease to determine if there is a correlation between a specific rearrangement or set of rearrangements and the disease.

In another aspect of the invention, the method may comprise comparing the immune cell profile identified for a population of individuals to whom a vaccine has been administered with the immune cell profile for a population of individuals to whom the vaccine was not administered to evaluate the efficacy of the vaccine in producing an immune response.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 a and FIG. 1 b are photographs of gels illustrating the presence of amplification products obtained by the method of the invention using primers disclosed herein.

FIG. 2 illustrates distributions of domain usage for (a) Ig heavy chain in healthy control sample, (b) TCR beta chain in a blood sample from a patient with colon cancer, (c) Ig kappa chain in a blood sample from a patient with Chronic Lymphocytic Leukemia (CLL), and (d) Ig lambda chain in a blood sample from a patient with Systemic lupus erythematosus (SLE). Empty spots indicate missing sequences associated with corresponding V-J combinations and the height of the column indicates the frequency of occurrence of a particular sequence.

DETAILED DESCRIPTION

The inventor has developed a method for evaluating antibody and receptor rearrangements from a large number of cells, the method being useful for comparing rearrangements identified in populations of individuals to determine whether there is a correlation between a specific rearrangement or set of rearrangements and a disease, or certain symptoms of a disease. The method is also useful for establishing a history of the immune response of an individual or individuals in response to infectious and/or environmental agents, as well as for evaluating the efficacy of vaccines.

The invention relates to a method for producing an immune status profile (ISP) for a human and/or animal. In one aspect of the invention, the method comprises the steps of amplifying, in a first amplification reaction using target-specific primers, at least one RNA from a sample of white blood cells from at least one human or animal subject to produce at least one amplicon, at least a portion of the target-specific primers comprising additional nucleotides to incorporate into a resulting amplicon a binding site for a common primer; rescuing the at least one amplicon from the first amplification reaction; amplifying, by the addition of common primers in a second amplification reaction, the amplicons of the first amplification reaction having at least one binding site for a common primer; and sequencing the amplicons of the second amplification reaction to identify and quantify DNA sequences representing antibody and/or receptor rearrangements to create an immune status profile.

Where the term “comprising” is used herein, “consisting essentially of” and “consisting of” may also be used. The term “immune status profile” is intended to mean a profile for an individual or population of individuals indicating the presence and/or absence of sequences representing specific rearrangements representing the diversity of B cells, T cells, and/or other cells of the human and/or animal immune system, as well as the frequency of their occurrence. Where amplicons are referred to as “rescued” herein, it is to be understood that amplicon rescue may occur by the separation of amplicons from the primers which are used to create them, or may occur by dilution of the amplicon/primer mix so that, by virtue of the fact that there are significantly more amplicons than primers from a first amplification reaction, the effect of those primers is minimized in a second amplification reaction using different primers. “Common primers” are those primers that may be used to amplify polynucleotides (e.g., amplicons from a first amplification produced by target-specific primers) having non-identical sequences in general, but sharing sequence similarities in that they contain binding sites for the same primers. Common primers are generally chosen for their efficiency at priming successful amplifications, so their use is effective for achieving higher levels of amplification in a non-target-specific manner in the method of the present invention. Common primer binding sites may be incorporated into amplicons resulting from a first amplification by attaching their sequences or their complementary sequences to the sequence of a target-specific primer. Common primers may be chosen by one of skill in the art by a variety of primer-design methods.

Subpopulations of white blood cells may be isolated by flow cytometry to separate naïve B cells, mature B cells, memory B cells, naïve T cells, mature T cells, and memory T cells. Recombinations in these subpopulations of cells are generally rearrangements of B-cell immunoglobulin heavy chain (IgH), kappa and/or lambda light chains (IgK, IgL), T-cell receptor Beta, Gamma, Delta, and/or Major Histocompatibility Complex (MHC) molecules I or II.

By performing an additional step, namely that of compiling and comparing the average immune status profile for a population of normal individuals with an average immune status profile for a population of individuals who have been diagnosed with a disease, it is possible to use the immune cell profile to determine if there is a correlation between a specific rearrangement or set of rearrangements and the disease.

The invention also provides a method for evaluating vaccine efficacy, in terms of creating a change in the immune cell profile, by performing the steps of the method and comparing the immune cell profile identified for a population of individuals to whom a vaccine has been administered with the immune cell profile for a population of individuals to whom the vaccine was not administered to evaluate the efficacy of the vaccine in producing an immune response.

In one embodiment of the invention, a peripheral blood sample is taken from a patient and isolation of a subpopulation of white blood cells may be performed by flow cytometry to separate naïve B cells, mature B cells, memory B cells, naïve T cells, mature T cells, and memory T cells. In various embodiments of the method, recombinations in the subpopulation of cells may comprise rearrangements of B-cell immunoglobulin heavy chain (IgH), kappa and/or lambda light chains (IgK, IgL), T-cell receptor Beta, Gamma, Delta, or Major Histocompatibility Complex (MHC) molecules I or II.

In some aspects, the step of rescuing the amplicons from the first amplification reaction may be omitted and the two amplification reactions may be performed in the same reaction tube without amplicon rescue or dilution of the primers remaining from the first amplification reaction.

The inventor previously developed a PCR method known as tem-PCR, which has been described in publication number WO2005/038039. More recently, the inventor has developed a method called amplicon rescue multiplex polymerase chain reaction (arm-PCR), which is described in U.S. PCT/US09/39552 and herein. Both the tem-PCR and arm-PCR methods provide semi-quantitative amplification of multiple polynucleotides in one reaction. Additionally, arm-PCR provides added sensitivity. Both provide the ability to amplify multiple polynucleotides in one reaction, which is beneficial in the present method because the repertoire of various T and B cells, for example, is so large. The addition of a common primer binding site in the amplification reaction, and the subsequent amplification of target molecules using common primers, gives a quantitative, or semi-quantitative result—making it possible to determine the relative amounts of the cells comprising various rearrangements within a patient blood sample. Clonal expansion due to recognition of antigen results in a larger population of cells which recognize that antigen, and evaluating cells by their relative numbers provides a method for determining whether an antigen exposure has influenced expansion of antibody-producing B cells or receptor-bearing T cells. This is helpful for evaluating whether there may be a particular population of cells that is prevalent in individuals who have been diagnosed with a particular disease, for example, and may be especially helpful in evaluating whether or not a vaccine has achieved the desired immune response in individuals to whom the vaccine has been given.

There are several commercially available high throughput sequencing technologies, such as Roche Life Sciences 454 Sequencing®. In this sequencing method, 454A and 454B primers are either linked onto PCR products during PCR or ligated on after the PCR reaction. When done in conjunction with tem-PCR or arm-PCR, 454A and 454B primers may be used as common primers in the amplification reactions. PCR products, usually a mixture of different sequences, are diluted to about 200 copies per μl. In an “emulsion PCR” reaction, (a semisolid gel like environment) the diluted PCR products are amplified by primers (454A or 454B) on the surface of the microbeads. Because the PCR templates are so dilute, usually only one bead is adjacent to one template, and confined in the semisolid environment, amplification only occurs on and around the beads. The beads are then eluted and put onto a plate with specially designed wells. Each well can only hold one bead. Reagents are then added into the wells to carry out pyrosequencing. A fiber-optic detector may be used to read the sequencing reaction from each well and the data is collected in parallel by a computer. One such high throughput reaction could generate up to 60 million reads (60 million beads) and each read can generate about 300 bp sequences.

One aspect of the invention involves the development of a database of immune status profiles, or “personal immunorepertoires” (PIRs), so that each individual may establish a baseline and follow the development of immune responses to antigens, both known and unknown, over a period of years. This information may, if information is gathered from a large number of individuals, provide an epidemiological database that will produce valuable information, particularly in regard to the development of those diseases such as cancer and heart disease which are thought to often arise from exposure to viral or other infectious agents, many of which have as yet been unidentified. One particularly important use for the method of the invention enables studies of children to determine whether infectious disease, environmental agents, or vaccines may be the cause of autism. For example, many have postulated that vaccine administration may trigger the development of autism. However, many also attribute that potential correlation to the use of agents such as thimerosol in the vaccine, and studies have demonstrated that thimerosol does not appear to be a causative agent of the disease. There is still speculation that the development of cocktail vaccines has correlated with the rise in the number of cases of autism, however, but gathering data to evaluate a potential causal connection for multiple antigens is extremely difficult. The method of the present invention simplifies that process and may provide key information for a better understanding of autism and other diseases in which the immune response of different individuals may provide an explanation for the differential development of disease in some individuals exposed to an agent or a group of agents, while others similarly exposed do not develop the disease.

Imbalances of the PIR, triggered by infection, may lead to many diseases, including cancers, leukemia, neuronal diseases (Alzheimer's, Multiple Sclerosis, Parkinson's, autism etc), autoimmune diseases, and metabolic diseases. These diseases may be called PIR diseases. There may be two PIR disease forms. (1) a “loss of function” form, and (2) a “gain of function” form. In the “loss of function” form, a person is susceptible to a disease because his/her restricted and/or limited PIR lacks the cells that produce the most efficient and necessary Igs and TRs. In the “gain of function” form, a person is susceptible to a disease because his/her PIR gained cells that produce Igs and TRs that normally should not be there. In the “loss of function” (LOF) PIR diseases, an individual does not have the appropriate functional B or T cells to fight a disease. His/her HLA typing determines that those cells are eliminated during the early stages of the immune cell maturation process, the cells generally being eliminated because they react to strongly to his/her own proteins.

One aspect of the invention also comprises entering a patient immune cell profile into a database in combination with identifying information such as, for example, a patient identification number, a code comprising the patient's HLA type, a disease code comprising one or more clinical diagnoses that may have been made, a “staging code” comprising the date of the sample, a cell type code comprising the type of cell subpopulation from which the RNA was amplified and sequenced, and one or more sequence codes comprising the sequences identified for the sample.

The described method includes a novel primer set that not only allows amplification of the entire immunorepertoire, but also allows multiplex amplification that is semi-quantitative. Multiplex amplification requires that only a few PCR or RT-PCR reactions are needed. For example, all immunoglobulin (Ig) sequences present may be amplified in one reaction, or two or three reactions may be performed separately, using primers specific for IgH, IgL or IgK. Similarly, the T-cell receptors (TRs) may be amplified in just one reaction, or may be amplified in a few reactions including the T-cell receptors designated TRA, TRB, TRD, and TRG. MHC genes may be amplified in just one PCR reaction. Semi-quantitative amplification allows all the targets in the multiplex reaction to be amplified independently, so that the end point analysis of the amplified products will reflect the original internal ratio among the targets. Because this ratio is maintained, it is possible to produce an immune cell profile that indicates the presence or absence, as well as relative numbers, of various immune system cells. Amplification of RNA according to the method of the invention may be performed using any or all of the primers listed in Tables 1, 2, and/or 3. The invention therefore provides a method for using at least one (which may, of course, more preferably include a least 2, at least 3, at least 4, etc.) primers chosen from among the group consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7, SEQ ID NO: 8, SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11, SEQ ID NO: 12, SEQ ID NO: 13, SEQ ID NO: 14, SEQ ID NO: 15, SEQ ID NO: 16, SEQ ID NO: 17, SEQ ID NO: 18, SEQ ID NO: 19, SEQ ID NO: 20, SEQ ID NO: 31, SEQ ID NO: 32, SEQ ID NO: 33, SEQ ID NO: 34, SEQ ID NO: 35, SEQ ID NO: 36, SEQ ID NO: 37, SEQ ID NO: 38, SEQ ID NO: 39, SEQ ID NO: 40, SEQ ID NO: 41, SEQ ID NO: 42, SEQ ID NO: 43, SEQ ID NO: 44, SEQ ID NO: 45, SEQ ID NO: 46, SEQ ID NO: 47, SEQ ID NO: 48, SEQ ID NO: 49, SEQ ID NO: 50, SEQ ID NO: 51, SEQ ID NO: 52, SEQ ID NO: 53, SEQ ID NO: 54, SEQ ID NO: 55, SEQ ID NO: 56, SEQ ID NO: 57, SEQ ID NO: 58, SEQ ID NO: 59, SEQ ID NO: 60, SEQ ID NO: 61, SEQ ID NO: 62, SEQ ID NO: 63, SEQ ID NO: 64, SEQ ID NO: 65, SEQ ID NO: 66, SEQ ID NO: 67, SEQ ID NO: 68, SEQ ID NO: 69, SEQ ID NO: 70, SEQ ID NO: 71, SEQ ID NO: 72, SEQ ID NO: 73, SEQ ID NO: 74, SEQ ID NO: 75, SEQ ID NO: 76, SEQ ID NO: 77, SEQ ID NO: 78, SEQ ID NO: 79, SEQ ID NO: 80, SEQ ID NO: 81, SEQ ID NO: 82, SEQ ID NO: 83, SEQ ID NO: 84, SEQ ID NO: 85, SEQ ID NO: 86, SEQ ID NO: 87, SEQ ID NO: 88, SEQ ID NO: 89, SEQ ID NO: 90, SEQ ID NO: 101, SEQ ID NO: 102, SEQ ID NO: 103, SEQ ID NO: 104, SEQ ID NO: 105, SEQ ID NO: 106, SEQ ID NO: 107, SEQ ID NO: 108, SEQ ID NO: 109, SEQ ID NO: 110, SEQ ID NO: 111, SEQ ID NO: 112, SEQ ID NO: 113, SEQ ID NO: 114, SEQ ID NO: 115, SEQ ID NO: 116, SEQ ID NO: 117, SEQ ID NO: 118, SEQ ID NO: 119, SEQ ID NO: 120, SEQ ID NO: 121, SEQ ID NO: 122, SEQ ID NO: 123, SEQ ID NO: 124, SEQ ID NO: 125, SEQ ID NO: 126, SEQ ID NO: 127, SEQ ID NO: 128, SEQ ID NO: 129, SEQ ID NO: 130, SEQ ID NO: 131, SEQ ID NO: 132, SEQ ID NO: 133, SEQ ID NO: 134, SEQ ID NO: 135, SEQ ID NO: 136, SEQ ID NO: 137, SEQ ID NO:138, SEQ ID NO: 139, SEQ ID NO: 140, SEQ ID NO: 151, SEQ ID NO: 152, SEQ ID NO: 153, SEQ ID NO: 154, SEQ ID NO: 155, SEQ ID NO: 156, SEQ ID NO: 157, SEQ ID NO: 158, SEQ ID NO: 159, SEQ ID NO: 160, SEQ ID NO: 161, SEQ ID NO: 162, SEQ ID NO: 163, SEQ ID NO: 164, SEQ ID NO: 165, SEQ ID NO: 166, SEQ ID NO: 167, SEQ ID NO: 168, SEQ ID NO: 169, SEQ ID NO: 170, SEQ ID NO: 171, SEQ ID NO: 172, SEQ ID NO: 173, SEQ ID NO: 174, SEQ ID NO: 175, SEQ ID NO: 176, SEQ ID NO: 177, SEQ ID NO: 178, SEQ ID NO: 179, SEQ ID NO: 180, SEQ ID NO: 181, SEQ ID NO: 182, SEQ ID NO: 183, SEQ ID NO: 184, SEQ ID NO: 185, SEQ ID NO: 186, SEQ ID NO: 187, SEQ ID NO: 188, SEQ ID NO: 189, SEQ ID NO: 190, SEQ ID NO: 191, SEQ ID NO: 192, SEQ ID NO: 193, SEQ ID NO: 194, SEQ ID NO: 195, SEQ ID NO: 196, SEQ ID NO: 197, SEQ ID NO: 198, SEQ ID NO: 199, SEQ ID NO: 200, SEQ ID NO: 201, SEQ ID NO: 202, SEQ ID NO: 203, SEQ ID NO: 204, SEQ ID NO: 205, SEQ ID NO: 206, SEQ ID NO: 207, SEQ ID NO: 208, SEQ ID NO: 209, SEQ ID NO: 210, SEQ ID NO: 211, SEQ ID NO: 212, SEQ ID NO: 213, SEQ ID NO: 214, SEQ ID NO: 215, SEQ ID NO: 216, SEQ ID NO: 217, SEQ ID NO: 218, SEQ ID NO: 219, SEQ ID NO: 220, SEQ ID NO: 221, SEQ ID NO: 222, SEQ ID NO: 223, SEQ ID NO: 224, SEQ ID NO: 225, SEQ ID NO: 226, SEQ ID NO: 227, SEQ ID NO: 228, SEQ ID NO: 229, SEQ ID NO: 230, SEQ ID NO: 231, SEQ ID NO: 232, SEQ ID NO: 233, SEQ ID NO: 234, SEQ ID NO: 235, SEQ ID NO: 236, SEQ ID NO: 237, SEQ ID NO: 238, SEQ ID NO: 239, SEQ ID NO: 240, SEQ ID NO: 241, SEQ ID NO: 242, SEQ ID NO: 243, SEQ ID NO: 244, SEQ ID NO: 245, SEQ ID NO: 246, SEQ ID NO: 247, SEQ ID NO: 248, SEQ ID NO: 249, SEQ ID NO: 250, SEQ ID NO: 251, SEQ ID NO: 252, SEQ ID NO: 253, SEQ ID NO: 254, SEQ ID NO: 255, SEQ ID NO: 256, SEQ ID NO: 257, SEQ ID NO: 258, SEQ ID NO: 259, SEQ ID NO: 260, SEQ ID NO: 261, SEQ ID NO: 262, SEQ ID NO: 263, SEQ ID NO: 264, SEQ ID NO: 265, SEQ ID NO: 266, SEQ ID NO: 267, SEQ ID NO: 268, SEQ ID NO: 269, SEQ ID NO: 270, SEQ ID NO: 271, SEQ ID NO: 272, SEQ ID NO: 273, SEQ ID NO: 274, SEQ ID NO: 275, SEQ ID NO: 276, SEQ ID NO: 277, SEQ ID NO: 278, SEQ ID NO: 279, SEQ ID NO: 280, SEQ ID NO: 281, SEQ ID NO: 282, SEQ ID NO: 283, SEQ ID NO: 284, SEQ ID NO: 285, SEQ ID NO: 286, SEQ ID NO: 287, SEQ ID NO: 288, SEQ ID NO: 289, SEQ ID NO: 290, SEQ ID NO: 291, SEQ ID NO: 292, SEQ ID NO: 293, SEQ ID NO: 294, SEQ ID NO: 295, SEQ ID NO: 296, SEQ ID NO: 297, SEQ ID NO: 298, SEQ ID NO: 299, SEQ ID NO: 300, SEQ ID NO: 301, SEQ ID NO: 302, SEQ ID NO: 303, SEQ ID NO: 304, SEQ ID NO: 305, SEQ ID NO: 306, SEQ ID NO: 307, SEQ ID NO: 308, SEQ ID NO: 309, SEQ ID NO: 310, SEQ ID NO: 311, SEQ ID NO: 312, and combinations thereof, to perform a first amplification producing at least one first amplicon, at least one of the target-specific primers containing additional base pairs so that the amplification results in the addition of a binding sequence for at least one common primer into the at least one first amplicon; amplifying the at least one first amplicon in a second amplification using at least one common primer to produce at least one second amplicon; and sequencing the at least one second amplicon to identify and quantify the sequences produced by the first and second amplifications. The listed primers were designed by the inventor to provide efficient amplification of their respective RNA and/or DNA targets. Use of the entire group of primers is effective to produce a detailed immune status profile for an individual. Use of a subset may, however, be desired when specific populations of T or B cells, for example, are the subject of particular interest.

By way of further explanation, the following example may be illustrative of the methods of the invention. Blood samples may be taken from children prior to administration of any vaccines, those blood samples for each child being used in the method of the invention to create a “baseline” immune status profile or personal immunorepertoire (PIR) from which future immune cell profiles, created from blood samples taken during later years and analyzed by the method of the invention, may be compared. For each child, the future samples may be utilized to determine whether there has been an exposure to an agent which has expanded a population of cells known to be correlated with a disease, and this may serve as a “marker” for the risk of development of the disease in the future. Individuals so identified may then be more closely monitored so that early detection is possible, and any available treatment options may be provided at an earlier stage in the disease process.

The method of the invention may be especially useful for identifying commonalities between individuals with autoimmune diseases, for example, and may provide epidemiological data that will better describe the correlation between infectious and environmental factors and diseases such as heart disease, atherosclerosis, diabetes, and cancer-providing biomarkers that signal either the presence of a disease, or the tendency to develop disease.

The method may also be useful for development of passive immunity therapies. For example, following exposure to an infectious agent, certain antibody-producing B cells and/or T cells are expanded. The method of the invention enables the identification of protective antibodies, for example, and those antibodies may be utilized to provide passive immunity therapies in situations where such therapy is needed.

The method of the invention may also provide the ability to accomplish targeted removal of cells with undesirable rearrangements, the method providing a means by which such cells rearrangements may be identified.

The inventor has identified and developed target-specific primers for use in the method of the invention. T-cell-specific primers are shown in Table 1, antibody-specific primers are shown in Table 2, and HLA-specific primers are shown in Table 3. Therefore, the method may comprise using any combination of primers of Table 1, Table 2, and/or Table 3 to amplify RNA and/or DNA from a blood sample, and more particularly to identify antibodies, T-cell receptors, and HLA molecules within a population of cells. For example, an analysis of T-cell distribution might utilize all or a portion of the primers listed in Table 1 (SEQ ID NO: 1 through SEQ ID NO: 157). An analysis of Ig might utilize all or a portion of the primers listed in Table 2 (SEQ ID NO: 158 through SEQ ID NO: 225), and an analysis of HLA distribution might utilize all or a portion of the primers listed in Table 3 (SEQ ID NO: 159 through SEQ ID NO: 312).

In a tem-PCR reaction, nested gene-specific primers are designed to enrich the targets during initial PCR cycling. Later, universal “Super” primers are used to amplify all targets. Primers are designated as F_(o) (forward out), F_(i) (forward in), R_(i) (reverse in), R_(o) (reverse out), FS (forward super primer) and RS, (reverse super primer), with super primers being common to a variety of the molecules due to the addition of a binding site for those primers at the end of a target-specific primer. The gene-specific primers (F_(o), F_(i), R_(i), and R_(o)) are used at extremely low concentrations. Different primers are involved in the tem-PCR process at each of the three major stages. First, at the “enrichment” stage, low-concentration gene-specific primers are given enough time to find the templates. For each intended target, depending on which primers are used, four possible products may be generated: F_(o)/R_(o), F_(i)/R_(o), F_(i)/R_(i), and F_(o)/R_(i). The enrichment stage is typically carried out for 10 cycles. In the second, or “tagging” stage, the annealing temperature is raised to 72° C., and only the long 40-nucleotide inside primers (Fi and Ri) will work. After 10 cycles of this tagging stage, all PCR products are “tagged” with the universal super primer sequences. Then, at the third “amplification” stage, high-concentration super primers work efficiently to amplify all targets and label the pCR products with biotin during the process. Specific probes may be covalently linked with Luminex® color-coated beads.

To amplify the genes coding for immunoglobulin superfamily molecules, the inventor designed nested primers based on sequence information available in the public domain. For studying B and T cell VDJ rearrangement, the inventor designed primers to amplify rearranged and expressed RNAs. Generally, a pair of nested forward primers is designed from the V genes and a set of reverse nested primers are designed from the J or C genes. The average amplicon size is 250-350 bp. For the IgHV genes, for example, there are 123 genes that can be classified into 7 different families, and the present primers are designed to be family-specific. However, if sequencing the amplified cDNA sequences, there are enough sequence diversities to allow further differentiation among the genes within the same family. For the MHC gene locus, the intent is to amplify genomic DNA.

The invention may be further described by means of the following non-limiting examples.

EXAMPLES Amplification of T or B Cell Rearrangement Sites

All oligos were resuspended using 1×TE. All oligos except 454A and 454B were resuspended to a concentration of 100 pmol/uL. 454A and 454B were resuspended to a concentration of 1000 pmol/uL 454A and 454B are functionally the same as the common primers described previously, the different sequences were used for follow up high throughput sequencing procedures.

Three different primer mixes were made. An Alpha Delta primer mix included 82 primers (all of TRAV-C+TRDV-C), a Beta Gamma primer mix included 79 primers (all of TRBVC and TRGV-C) and a B cell primer mix that included a total of 70 primers. F_(o), F_(i), and R_(i) primers were at a concentration of 1 pmol/μL. R_(o) primers were at a concentration of 5 pmol/uL. 454A and 454B were at a concentration of 30 pmol/μL.

Three different RNA samples were ordered from ALLCELLS (www.allcells.com). All samples were diluted down to a final concentration of 4 ng/uL. The samples used were: ALL-PB-MNC (from a patient with acute lymphoblastic leukemia), NPB-Pan T Cells (normal T cells) and NPB-B Cells (normal B cells).

RT-PCR was performed using a Qiagen® One-Step RT-PCR kit. Each sample contained the following:

10 μL of Qiagen® Buffer

2 μL of DNTP's

2 μl of Enzyme

23.5 μL of dH2O

10 μL of the appropriate primer mix

2.5 μL of the appropriate template (long of RNA total)

The samples were run using the following cycling conditions:

50° C. for 30 minutes

95° C. for 15 minutes

94° C. for 30 seconds

15 cycles of

55° C. for 1 minute

72° C. for 1 minute

94° C. for 15 seconds

6 cycles of

70° C. for 1 minute 30 seconds

94° C. for 15 seconds

30 cycles of

55° C. for 15 seconds

72° C. for 15 seconds

72° C. for 3 minutes

4° C. Hold

The order of samples placed in the gel shown in FIG. 1 a was: (1) Ladder (500 bp being the largest working down in steps of 20 bp, the middle bright band in FIG. 1 a is 200 bp); (2) α+δ primer mix with 10 ng Pan T Cells Template; (3) β+γ primer mix with 10 ng Pan T Cells Template; (4) B Cell primer mix with 10 ng B Cells Template; (5) B Cell primer mix with 10 ng ALL Cells Template; (6) α+δ primer mix with 10 ng ALL Cells Template; (7) β+γ primer mix with 10 ng ALL Cells Template; 8. α+δ primer mix blank; (9) β+γ primer mix blank; (10) B Cell primer mix blank; (11) Running buffer blank. These samples were run on a pre-cast ClearPAGE® SDS 10% gel using 1× ClearPAGE® DNA native running buffer.

The initial experiment showed that a smear is generated from PCR reactions where templates were included. The smears indicate different sizes of PCR products were generated that represented a mixture of different VDJ rearrangements. There was some background amplification from the B cell reaction. Further improvement on that primer mix cleaned up the reaction.

To determine whether the PCR products indeed include different VDJ rearrangements, it was necessary to isolate and sequence the single clones. Instead of using the routine cloning procedures, the inventor used a different strategy. PCR products generated from the Alpha Delta mix and the Beta Gamma mix (lanes 2 and 3 in FIG. 1 a) were diluted 1:1000 and a 2 μl aliquot used as PCR template in the following reaction. Then, instead of using a mixture of primers that targeting the entire repertoire, one pair of specific F_(i) and R_(i) primers were used (5 pmol each) to amplify only one specific PCR product. The following cycling conditions were used to amplify the samples:

95° C. for 5 minutes

30 cycles of

94° C. for 30 seconds

72° C. for 1 minute

72° C. for 3 minutes

4° C. hold

A Qiagen PCR kit was used to amplify the products. The Master Mix used for the PCR contained the following: 5 μL 10×PCR Buffer, 1 μL dNTP, 0.25 μL HotStartTaq Plus, and 39.75 μL H₂O. (For a mix for 12 reactions: 60 μL 10×PCR Buffer, 12 μL dNTP, 3 μL HotStartTaq Plus, and 477 μL H₂O.)

The photograph of the gel in FIG. 1 b shows the PCR products of the following reactions: (1) Ladder; (2) TRAV1F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (3) TRAV2F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (4) TRAV3F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (5) TRAV4F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (6) TRAV5F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (7) TRAV1F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (8) TRAV2F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (9) TRAV3F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (10) TRAV4F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (11) TRAV5F_(i)+TRACR_(i) with alpha delta Pan T PCR product; (12) PCR Blank. Primers listed as F₁ are “forward inner” primers and primers listed as F_(o) are “forward outer” primers, with R_(i) and R_(o) indicating “reverse inner” and “reverse outer” primers, respectively.

As illustrated by FIG. 1 b, a single PCR product was generated from each reaction. Different size bands were generated from different reactions. This PCR cloning approach is successful for two major reasons—(1) The PCR templates used in this reaction were diluted PCR products (1:1000) of previous reactions that used primer mixes to amplify all possible VDJ rearrangements (for example, a primer mix was used that included total of 82 primers to amplify T cell receptor Alpha and Delta genes) and (2) Only one pair of PCR primers, targeting a specific V gene, are used in each reaction during this “cloning” experiment. In every case, a single clone was obtained, and a specific T cell receptor V gene that matched the F_(i) primer was identified.

Sequencing of Immune Cell RNA Using Primers of SEQ ID NO: 1-SEQ ID NO: 312

Pan-T, pan-B, and neutrophil isolation was performed using super-paramagnetic polystyrene beads coated with monoclonal antibody specific for certain cell types (Dynabeads®, Invitrogen Corp., Carlsbad, Calif.) following manufacturer's instructions. Anti-CD3 beads were used to isolate pan-T cells, anti-CD19 beads for pan-B cells, and anti-CD15 beads for neutrophils. Isolated cells were resuspended in 300 μl RNAProtect® (Qiagen) reagent and counted using a hemacytometer.

T cell subpopulations were isolated from a normal patient 48-year-old Asian male. PMBCs were obtained from 40 ml of whole blood collected in sodium heparin by density centrifugation over Ficoll Prep Plus Reagent. Pan-T cells were isolated from the mononuclear layer using a magnetic bead isolation kit (Miltenyi Biotec, Auburn, Calif.), following manufacturer's instructions. Anti-CD4 and anti-CD25 beads were used to isolate regulatory T cells, anti-CD56 for NKT cells, anti-CD8 for cytotoxic T cells, and anti-CD4 and anti-CD294 for Th2 cells. Th1 cells were isolated via negative selection. A separate 40 ml sample of whole blood collected in sodium heparin was used to obtain naive, activated, and memory T cell subpopulations. Anti-CD45RA beads were used to isolate naive T cells, anti-CD69 for activated T cells and anti-CD45RO beads for memory T cells. Isolated cells were re-suspended in 300 μl of RNAProtect® reagent (Qiagen). Cells were counted using a hemacytometer.

DNA extraction from the isolated neutrophils was performed using a QIAmp® DNA mini kit (Qiagen) using the protocol provided by the manufacturer. RNA was extracted from T cell subsets using an Rneasy® kit (Qiagen) according to the protocol provided by the manufacturer. The concentrations of extracted DNA and RNA were measured using Nanodrop® technology (Nanodrop Technologies, Wilmington, Del.). Samples were stored at −80° C.

RT-PCR was performed according to the method of the invention using nested PCR to amplify multiple targets and target-specific primers to incorporate a common primer binding sequence into the resulting amplicons in a first amplification reaction. Common primers were then used in a second amplification reaction to exponentially amplify the amplicons rescued from the first amplification reaction while preserving the relative ratios of each amplicon. PCR was performed using a One-Step RT-PCR kit (Qiagen). DNA amplification for HLA typing was similarly performed, but with a mulitplex PCR kit (Qiagen). Each amplicon mixture was subjected to high-throughput sequencing with the Roche 454 sequencing platform.

More than 1.6 million effective sequences were generated for one single individual (normal 48-year-old Asian male) by sampling different subpopulations of lymphocytes in peripheral blood at different time points. Additionally, 170,734 effective sequences were generated for the colon cancer, CLL, SLE, and a second healthy patient (a 32-year-old Caucasian male). The number of unique reads generated in this study was compared to the number of unique reads existing in public databases in Table 1. The public sequence data set was compiled by searching Genbank nucleotide database with terms of ‘human[orgn] AND (immunoglobulin[titl] OR T-cell receptor[titl]) AND mRNA[titl]’. In addition, the annotated IMGT/LIGM-DB (Brezinschek et al, 1995) cDNA sequences were gathered with a Python script. The two data sets were merged, and one copy was kept for any redundant sequences.

Biased usage of V, and J gene segments in a healthy control, CLL, colon cancer, and SLE sample was analyzed. The bias of domain usage was particularly outstanding for TCR beta chain in the colon cancer sample and SLE sample, while in the healthy control sample the domain usage is quite normal without significant bias to any particular domain. It was evident that colon cancer and SLE profiles not only show clonal expansion, but demonstrate the loss of overall diversity, as well.

The distribution of functional germline V, J gene segments seen in the pan-T and pan-B populations from normal patient indicated that 87.2% of potential combinations have sequences observed. Only IGHV3-d was not observed in this investigation, while TRBV4-3, IGHV3-d, IGHV4-30-4 and IGHV4-31 and IGHL3-22 were observed in other samples with extremely low frequency. Previous research did not reveal any cDNA sequence data related to IGHV3-d, which suggests that IGHV3-d may be used infrequently. Some sequences were present in high (e.g. 1000) numbers, while others were present in significantly lower numbers. The inventor believes that higher numbers represent lymphocyte clonal expansions, reflecting the real immune responses in the subject. Studies of VH gene distribution in normal individuals have previously found the frequency of usage in general to be similar to the germline complexity, while many immune responses show some level of bias in the usage of V, D and J gene segments.

TABLE 1 Sequence Primer Sequence ID Number TRAV1Fo 5′-TGCACGTACCAGACATCTGG-3′ SEQ ID NO: 1 TRAV1Fi AGGTCGTTTTTCTTCATTCC SEQ ID NO: 2 TRAV2Fo TCTGTAATCACTCTGTGTCC SEQ ID NO: 3 TRAV2Fi AGGGACGATACAACATGACC SEQ ID NO: 4 TRAV3Fo CTATTCAGTCTCTGGAAACC SEQ ID NO: 5 TRAV3Fi ATACATCACAGGGGATAACC SEQ ID NO: 6 TRAV4Fo TGTAGCCACAACAACATTGC SEQ ID NO: 7 TRAV4Fi AAAGTTACAAACGAAGTGGC SEQ ID NO: 8 TRAV5Fo GCACTTACACAGACAGCTCC SEQ ID NO: 9 TRAV5Fi TATGGACATGAAACAAGACC SEQ ID NO: 10 TRAV6Fo GCAACTATACAAACTATTCC SEQ ID NO: 11 TRAV6Fi GTTTTCTTGCTACTCATACG SEQ ID NO: 12 TRAV7Fo TGCACGTACTCTGTCAGTCG SEQ ID NO: 13 TRAV7Fi GGATATGAGAAGCAGAAAGG SEQ ID NO: 14 TRAV8Fo AATCTCTTCTGGTATGTSCA SEQ ID NO: 15 TRAV8Fi GGYTTTGAGGCTGAATTTA SEQ ID NO: 16 TRAV9Fo GTCCAATATCCTGGAGAAGG SEQ ID NO: 17 TRAV9Fi AACCACTTCTTTCCACTTGG SEQ ID NO: 18 TRAV10Fo AATGCAATTATACAGTGAGC SEQ ID NO: 19 TRAV10Fi TGAGAACACAAAGTCGAACG SEQ ID NO: 20 TRAV11Fo TCTTAATTGTACTTATCAGG SEQ ID NO: 21 TRAV11Fi TCAATCAAGCCAGAAGGAGC SEQ ID NO: 22 TRAV12Fo TCAGTGTTCCAGAGGGAGCC SEQ ID NO: 23 TRAV12Fi ATGGAAGGTTTACAGCACAG SEQ ID NO: 24 TRAV13Fo ACCCTGAGTGTCCAGGAGGG SEQ ID NO: 25 TRAV13Fi TTATAGACATTCGTTCAAAT SEQ ID NO: 26 TRAV14Fo TGGACTGCACATATGACACC SEQ ID NO: 27 TRAV14Fi CAGCAAAATGCAACAGAAGG SEQ ID NO: 28 TRAV16Fo AGCTGAAGTGCAACTATTCC SEQ ID NO: 29 TRAV16Fi TCTAGAGAGAGCATCAAAGG SEQ ID NO: 30 TRAV17Fo AATGCCACCATGAACTGCAG SEQ ID NO: 31 TRAV17Fi GAAAGAGAGAAACACAGTGG SEQ ID NO: 32 TRAV18Fo GCTCTGACATTAAACTGCAC SEQ ID NO: 33 TRAV18Fi CAGGAGACGGACAGCAGAGG SEQ ID NO: 34 TRAV19Fo ATGTGACCTTGGACTGTGTG SEQ ID NO: 35 TRAV19Fi GAGCAAAATGAAATAAGTGG SEQ ID NO: 36 TRAV20Fo ACTGCAGTTACACAGTCAGC SEQ ID NO: 37 TRAV20Fi AGAAAGAAAGGCTAAAAGCC SEQ ID NO: 38 TRAV21Fo ACTGCAGTTTCACTGATAGC SEQ ID NO: 39 TRAV21Fi CAAGTGGAAGACTTAATGCC SEQ ID NO: 40 TRAV22Fo GGGAGCCAATTCCACGCTGC SEQ ID NO: 41 TRAV22Fi ATGGAAGATTAAGCGCCACG SEQ ID NO: 42 TRAV23Fo ATTTCAATTATAAACTGTGC SEQ ID NO: 43 TRAV23Fi AAGGAAGATTCACAATCTCC SEQ ID NO: 44 TRAV24Fo GCACCAATTTCACCTGCAGC SEQ ID NO: 45 TRAV24Fi AGGACGAATAAGTGCCACTC SEQ ID NO: 46 TRAV25Fo TCACCACGTACTGCAATTCC SEQ ID NO: 47 TRAV25Fi AGACTGACATTTCAGTTTGG SEQ ID NO: 48 TRAV26Fo TCGACAGATTCMCTCCCAGG SEQ ID NO: 49 TRAV26Fi GTCCAGYACCTTGATCCTGC SEQ ID NO: 50 TRAV27Fo CCTCAAGTGTTTTTTCCAGC SEQ ID NO: 51 TRAV27Fi GTGACAGTAGTTACGGGTGG SEQ ID NO: 52 TRAV29Fo CAGCATGTTTGATTATTTCC SEQ ID NO: 53 TRAV29Fi ATCTATAAGTTCCATTAAGG SEQ ID NO: 54 TRAV30Fo CTCCAAGGCTTTATATTCTG SEQ ID NO: 55 TRAV30Fi ATGATATTACTGAAGGGTGG SEQ ID NO: 56 TRAV34Fo ACTGCACGTCATCAAAGACG SEQ ID NO: 57 TRAV34Fi TTGATGATGCTACAGAAAGG SEQ ID NO: 58 TRAV35Fo TGAACTGCACTTCTTCAAGC SEQ ID NO: 59 TRAV35Fi CTTGATAGCCTTATATAAGG SEQ ID NO: 60 TRAV36Fo TCAATTGCAGTTATGAAGTG SEQ ID NO: 61 TRAV36Fi TTTATGCTAACTTCAAGTGG SEQ ID NO: 62 TRAV38Fo GCACATATGACACCAGTGAG SEQ ID NO: 63 TRAV38Fi TCGCCAAGAAGCTTATAAGC SEQ ID NO: 64 TRAV39Fo TCTACTGCAATTATTCAACC SEQ ID NO: 65 TRAV39Fi CAGGAGGGACGATTAATGGC SEQ ID NO: 66 TRAV40Fo TGAACTGCACATACACATCC SEQ ID NO: 67 TRAV40Fi ACAGCAAAAACTTCGGAGGC SEQ ID NO: 68 TRAV41Fo AACTGCAGTTACTCGGTAGG SEQ ID NO: 69 TRAV41Fi AAGCATGGAAGATTAATTGC SEQ ID NO: 70 TRACRo GCAGACAGACTTGTCACTGG SEQ ID NO: 71 TRACRi AGTCTCTCAGCTGGTACACG SEQ ID NO: 72 TRBV1Fo AATGAAACGTGAGCATCTGG SEQ ID NO: 73 TRBV1Fi CATTGAAAACAAGACTGTGC SEQ ID NO: 74 TRBV2Fo GTGTCCCCATCTCTAATCAC SEQ ID NO: 75 TRBV2Fi TGAAATCTCAGAGAAGTCTG SEQ ID NO: 76 TRBV3Fo TATGTATTGGTATAAACAGG SEQ ID NO: 77 TRBV3Fi CTCTAAGAAATTTCTGAAGA SEQ ID NO: 78 TRBV4Fo GTCTTTGAAATGTGAACAAC SEQ ID NO: 79 TRBV4Fi GGAGCTCATGTTTGTCTACA SEQ ID NO: 80 TRBV5Fo GATCAAAACGAGAGGACAGC SEQ ID NO: 81 TRBV5aFi CAGGGGCCCCAGTTTATCTT SEQ ID NO: 82 TRBV5bFi GAAACARAGGAAACTTCCCT SEQ ID NO: 83 TRBV6aFo GTGTGCCCAGGATATGAACC SEQ ID NO: 84 TRBV6bFo CAGGATATGAGACATAATGC SEQ ID NO: 85 TRBV6aFi GGTATCGACAAGACCCAGGC SEQ ID NO: 86 TRBV6bFi TAGACAAGATCTAGGACTGG SEQ ID NO: 87 TRBV7Fo CTCAGGTGTGATCCAATTTC SEQ ID NO: 88 TRBV7aFi TCTAATTTACTTCCAAGGCA SEQ ID NO: 89 TRBV7bFi TCCCAGAGTGATGCTCAACG SEQ ID NO: 90 TRBV7cFi ACTTACTTCAATTATGAAGC SEQ ID NO: 91 TRBV7dFi CCAGAATGAAGCTCAACTAG SEQ ID NO: 92 TRBV9Fo GAGACCTCTCTGTGTACTGG SEQ ID NO: 93 TRBV9Fi CTCATTCAGTATTATAATGG SEQ ID NO: 94 TRBV10Fo GGAATCACCCAGAGCCCAAG SEQ ID NO: 95 TRBV10Fi GACATGGGCTGAGGCTGATC SEQ ID NO: 96 TRBV11Fo CCTAAGGATCGATTTTCTGC SEQ ID NO: 97 TRBV11Fi ACTCTCAAGATCCAGCCTGC SEQ ID NO: 98 TRBV12Fo AGGTGACAGAGATGGGACAA SEQ ID NO: 99 TRBV12aFi TGCAGGGACTGGAATTGCTG SEQ ID NO: 100 TRBV12bFi GTACAGACAGACCATGATGC SEQ ID NO: 101 TRBV13Fo CTATCCTATCCCTAGACACG SEQ ID NO: 102 TRBV13Fi AAGATGCAGAGCGATAAAGG SEQ ID NO: 103 TRBV14Fo AGATGTGACCCAATTTCTGG SEQ ID NO: 104 TRBV14Fi AGTCTAAACAGGATGAGTCC SEQ ID NO: 105 TRBV15Fo TCAGACTTTGAACCATAACG SEQ ID NO: 106 TRBV15Fi AAAGATTTTAACAATGAAGC SEQ ID NO: 107 TRBV16Fo TATTGTGCCCCAATAAAAGG SEQ ID NO: 108 TRBV16Fi AATGTCTTTGATGAAACAGG SEQ ID NO: 109 TRBV17Fo ATCCATCTTCTGGTCACATG SEQ ID NO: 110 TRBV17Fi AACATTGCAGTTGATTCAGG SEQ ID NO: 111 TRBV18Fo GCAGCCCAATGAAAGGACAC SEQ ID NO: 112 TRBV18Fi AATATCATAGATGAGTCAGG SEQ ID NO: 113 TRBV19Fo TGAACAGAATTTGAACCACG SEQ ID NO: 114 TRBV19Fi TTTCAGAAAGGAGATATAGC SEQ ID NO: 115 TRBV20Fo TCGAGTGCCGTTCCCTGGAC SEQ ID NO: 116 TRBV20Fi GATGGCAACTTCCAATGAGG SEQ ID NO: 117 TRBV21Fo GCAAAGATGGATTGTGTTCC SEQ ID NO: 118 TRBV21Fi CGCTGGAAGAAGAGCTCAAG SEQ ID NO: 119 TRBV23Fo CATTTGGTCAAAGGAAAAGG SEQ ID NO: 120 TRBV23Fi GAATGAACAAGTTCTTCAAG SEQ ID NO: 121 TRBV24Fo ATGCTGGAATGTTCTCAGAC SEQ ID NO: 122 TRBV24Fi GTCAAAGATATAAACAAAGG SEQ ID NO: 123 TRBV25Fo CTCTGGAATGTTCTCAAACC SEQ ID NO: 124 TRBV25Fi TAATTCCACAGAGAAGGGAG SEQ ID NO: 125 TRBV26Fo CCCAGAATATGAATCATGTT SEQ ID NO: 126 TRBV26Fi ATTCACCTGGCACTGGGAGC SEQ ID NO: 127 TRBV27Fo TTGTTCTCAGAATATGAACC SEQ ID NO: 128 TRBV27Fi TGAGGTGACTGATAAGGGAG SEQ ID NO: 129 TRBV28Fo ATGTGTCCAGGATATGGACC SEQ ID NO: 130 TRBV28Fi AAAAGGAGATATTCCTGAGG SEQ ID NO: 131 TRBV29Fo TCACCATGATGTTCTGGTAC SEQ ID NO: 132 TRBV29Fi CTGGACAGAGCCTGACACTG SEQ ID NO: 133 TRBV30Fo TGTGGAGGGAACATCAAACC SEQ ID NO: 134 TRBV30Fi TTCTACTCCGTTGGTATTGG SEQ ID NO: 135 TRBCRo GTGTGGCCTTTTGGGTGTGG SEQ ID NO: 136 TRBCRi TCTGATGGCTCAAACACAGC SEQ ID NO: 137 TRDV1Fo TGTATGAAACAAGTTGGTGG SEQ ID NO: 138 TRDV1Fi CAGAATGCAAAAAGTGGTCG SEQ ID NO: 139 TRDV2Fo ATGAAAGGAGAAGCGATCGG SEQ ID NO: 140 TRDV2Fi TGGTTTCAAAGACAATTTCC SEQ ID NO: 141 TRDV3Fo GACACTGTATATTCAAATCC SEQ ID NO: 142 TRDV3Fi GCAGATTTTACTCAAGGACG SEQ ID NO: 143 TRDCRo AGACAAGCGACATTTGTTCC SEQ ID NO: 144 TRDCRi ACGGATGGTTTGGTATGAGG SEQ ID NO: 145 TRGV1-5Fo GGGTCATCTGCTGAAATCAC SEQ ID NO: 146 TRGV1- AGGAGGGGAAGGCCCCACAG SEQ ID NO: 147 5, 8Fi TRGV8Fo GGGTCATCAGCTGTAATCAC SEQ ID NO: 148 TRGV5pFi AGGAGGGGAAGACCCCACAG SEQ ID NO: 149 TRGV9Fo AGCCCGCCTGGAATGTGTGG SEQ ID NO: 150 TRGV9Fi GCACTGTCAGAAAGGAATCC SEQ ID NO: 151 TRGV10Fo AAGAAAAGTATTGACATACC SEQ ID NO: 152 TRGV10Fi ATATTGTCTCAACAAAATCC SEQ ID NO: 153 TRGV11Fo AGAGTGCCCACATATCTTGG SEQ ID NO: 154 TRGV11Fi GCTCAAGATTGCTCAGGTGG SEQ ID NO: 155 TRGCRo GGATCCCAGAATCGTGTTGC SEQ ID NO: 156 TRGCRi GGTATGTTCCAGCCTTCTGG SEQ ID NO: 157

TABLE 2 Sequence Primer Sequence ID Number IgHV1aFo AGTGAAGGTCTCCTGCAAGG SEQ ID NO: 158 IgHV1bFo AGTGAAGGTTTCCTGCAAGG SEQ ID NO: 159 IgHV1aFi AGTTCCAGGGCAGAGTCAC SEQ ID NO: 160 IgHV1bFi AGTTTCAGGGCAGGGTCAC SEQ ID NO: 161 IgHV1cFi AGTTCCAGGAAAGAGTCAC SEQ ID NO: 162 IgHV1dFi AATTCCAGGACAGAGTCAC SEQ ID NO: 163 IgHV2Fo TCTCTGGGTTCTCACTCAGC SEQ ID NO: 164 IgHV2Fi AAGGCCCTGGAGTGGCTTGC SEQ ID NO: 165 IgHV3aFo TCCCTGAGACTCTCCTGTGC SEQ ID NO: 166 IgHV3bFo CTCTCCTGTGCAGCCTCTGG SEQ ID NO: 167 IgHV3cFo GGTCCCTGAGACTCTCCTGT SEQ ID NO: 168 IgHV3dFo CTGAGACTCTCCTGTGTAGC SEQ ID NO: 169 IgHV3aFi CTCCAGGGAAGGGGCTGG SEQ ID NO: 170 IgHV3bFi GGCTCCAGGCAAGGGGCT SEQ ID NO: 171 IgHV3cFi ACTGGGTCCGCCAGGCTCC SEQ ID NO: 172 IgHV3dFi GAAGGGGCTGGAGTGGGT SEQ ID NO: 173 IgHV3eFi AAAAGGTCTGGAGTGGGT SEQ ID NO: 174 IgHV4Fo AGACCCTGTCCCTCACCTGC SEQ ID NO: 175 IgHV4Fi AGGGVCTGGAGTGGATTGGG SEQ ID NO: 176 IgHV5Fo GCGCCAGATGCCCGGGAAAG SEQ ID NO: 177 IgHV5Fi GGCCASGTCACCATCTCAGC SEQ ID NO: 178 IgHV6Fo CCGGGGACAGTGTCTCTAGC SEQ ID NO: 179 IgHV6Fi GCCTTGAGTGGCTGGGAAGG SEQ ID NO: 180 IgHV7Fo GTTTCCTGCAAGGCTTCTGG SEQ ID NO: 181 IgHV7Fi GGCTTGAGTGGATGGGATGG SEQ ID NO: 182 IgHJRo ACCTGAGGAGACGGTGACC SEQ ID NO: 183 IgHJ1Ri CAGTGCTGGAAGTATTCAGC SEQ ID NO: 184 IgHJ2Ri AGAGATCGAAGTACCAGTAG SEQ ID NO: 185 IgHJ3Ri CCCCAGATATCAAAAGCATC SEQ ID NO: 186 IgHJ4Ri GGCCCCAGTAGTCAAAGTAG SEQ ID NO: 187 IgHJ5Ri CCCAGGGGTCGAACCAGTTG SEQ ID NO: 188 IgHJ6Ri CCCAGACGTCCATGTAGTAG SEQ ID NO: 189 IgKV1Fo TAGGAGACAGAGTCACCATC SEQ ID NO: 190 IgKV1Fi TTCAGYGRCAGTGGATCTGG SEQ ID NO: 191 IgKV2Fo GGAGAGCCGGCCTCCATCTC SEQ ID NO: 192 IgKV2aFi TGGTACCTGCAGAAGCCAGG SEQ ID NO: 193 IgKV2bFi CTTCAGCAGAGGCCAGGCCA SEQ ID NO: 194 IgKV3-7Fo GCCTGGTACCAGCAGAAACC SEQ ID NO: 195 IgKV3Fi GCCAGGTTCAGTGGCAGTGG SEQ ID NO: 196 IgKV6-7Fi TCGAGGTTCAGTGGCAGTGG SEQ ID NO: 197 IgKV4-5Fi GACCGATTCAGTGGCAGCGG SEQ ID NO: 198 IgKCRo TTCAACTGCTCATCAGATGG SEQ ID NO: 199 IgKCRi ATGAAGACAGATGGTGCAGC SEQ ID NO: 200 IgLV1aFo GGGCAGAGGGTCACCATCTC SEQ ID NO: 201 IgLV1bFo GGACAGAAGGTCACCATCTC SEQ ID NO: 202 IgLV1aFi TGGTACCAGCAGCTCCCAGG SEQ ID NO: 203 IgLV1bFi TGGTACCAGCAGCTTCCAGG SEQ ID NO: 204 IgLV2Fo CTGCACTGGAACCAGCAGTG SEQ ID NO: 205 IgLV2Fi TCTCTGGCTCCAAGTCTGGC SEQ ID NO: 206 IgLV3aFo ACCAGCAGAAGCCAGGCCAG SEQ ID NO: 207 IgLV3bFo GAAGCCAGGACAGGCCCCTG SEQ ID NO: 208 IgLV3aFi CTGAGCGATTCTCTGGCTCC SEQ ID NO: 209 IgLV3bFi TTCTCTGGGTCCACCTCAGG SEQ ID NO: 210 IgLV3cFi TTCTCTGGCTCCAGCTCAGG SEQ ID NO: 211 IgLV4Fo TCGGTCAAGCTCACCTGCAC SEQ ID NO: 212 IgLV4Fi GGGCTGACCGCTACCTCACC SEQ ID NO: 213 IgLV5Fo CAGCCTGTGCTGACTCAGCC SEQ ID NO: 214 IgLV5Fi CCAGCCGCTTCTCTGGATCC SEQ ID NO: 215 IgLV6Fo CCATCTCCTGCACCCGCAGC SEQ ID NO: 216 IgLV7-8Fo TCCCCWGGAGGGACAGTCAC SEQ ID NO: 217 IgLV9, CTCMCCTGCACCCTGAGCAG SEQ ID NO: 218 11Fo IgLV10Fo AGACCGCCACACTCACCTGC SEQ ID NO: 219 IgLV6, 8Fi CTGATCGSTTCTCTGGCTCC SEQ ID NO: 220 IgLV7Fi CTGCCCGGTTCTCAGGCTCC SEQ ID NO: 221 IgLV9Fi ATCCAGGAAGAGGATGAGAG SEQ ID NO: 222 IgLV10- CTCCAGCCTGAGGACGAGGC SEQ ID NO: 223 11Fi IgLC1-7Ro GCTCCCGGGTAGAAGTCACT SEQ ID NO: 224 IgLC1-7Ri AGTGTGGCCTTGTTGGCTTG SEQ ID NO: 225

TABLE 3 Primer Sequence Sequence ID Number HLAI CCCACTCCATGAGGTATTTC SEQ ID NO: 226 Fo11 HLAI CCTACTCCATGAGGTATTTC SEQ ID NO: 227 Fo12 HLAI GCGGGGAGCCCCGCTTCATC SEQ ID NO: 228 Fo31 HLAI GCGGGAAGCCCCGCTTCATC SEQ ID NO: 229 Fo32 HLAI GTGGAGAGCCCCGCTTCATC SEQ ID NO: 230 Fo33 HLAI GCGGAAAGCCCCGCTTCATC SEQ ID NO: 231 Fo34 HLAI GCGGAAAGCCCCACTTCATC SEQ ID NO: 232 Fo35 HLAI GCGGGAAGCCCCACTTCATC SEQ ID NO: 233 Fo36 HLAI GTGGGCTACGTGGACGACAC SEQ ID NO: 234 Fi11 HLAI GTGGGCTACGTGGACGGCAC SEQ ID NO: 235 Fi12 HLAI- GTTCGTGCGGTTCGACAGCG SEQ ID NO: 236 Fi21 HLAI- GTTCGTGCGGTTTGACAGCG SEQ ID NO: 237 Fi22 HLAI- GTTCGTGAGGTTCGACAGCG SEQ ID NO: 238 Fi23 HLAI TAATCCTTGCCGTCGTAGGC SEQ ID NO: 239 Ri11 HLAI TAATCCTTGCCGTCGTAAGC SEQ ID NO: 240 Ri12 HLAI TAATCTTTGCCGTCGTAGGC SEQ ID NO: 241 Ri13 HLAI GGTCCTCGTTCAGGGCGATG SEQ ID NO: 242 Ro11 HLAI GGTCCTCTTTCAGGGCGATG SEQ ID NO: 243 Ro12 HLAI GGTCCTCGTTCAAGGCGATG SEQ ID NO: 244 Ro13 HLAI GATCCTCGTTCAGGGCGATG SEQ ID NO: 245 Ro14 HLAI GGTCCTCATTCAGGGCGATG SEQ ID NO: 246 Ro15 HLAI- GCCTACGACGGCAAGGATTA SEQ ID NO: 247 Fo41 HLAI- GCTTACGACGGCAAGGATTA SEQ ID NO: 248 Fo42 HLAI- GCCTACGACGGCAAAGATTA SEQ ID NO: 249 Fo43 HLAI- CATCGCCCTGAACGAGGACC SEQ ID NO: 250 Fi31 HLAI- CATCGCCCTGAAAGAGGACC SEQ ID NO: 251 Fi32 HLAI- CATCGCCTTGAACGAGGACC SEQ ID NO: 252 Fi33 HLAI- CATCGCCCTGAACGAGGATC SEQ ID NO: 253 Fi34 HLAI- CATCGCCCTGAATGAGGACC SEQ ID NO: 254 Fi35 HLAI- GGTATCTGCGGAGCCCGTCC SEQ ID NO: 255 Ri21 HLAI- GGTATCTGCGGAGCCACTCC SEQ ID NO: 256 Ri22 HLAI- GGTGTCTGCGGAGCCACTCC SEQ ID NO: 257 Ri23 HLAI- GGTATCCGCGGAGCCACTCC SEQ ID NO: 258 Ri24 HLAI- GCAGCGTCTCCTTCCCGTTC SEQ ID NO: 259 Ro21 HLAI- CCAGCTTGTCCTTCCCGTTC SEQ ID NO: 260 Ro22 HLAI- CCAGCGTGTCCTTCCCGTTC SEQ ID NO: 261 Ro23 HLAI- GCAGCGTCTCCTTCCCATTC SEQ ID NO: 262 Ro24 HLAI- GCAGCGTCTCCTTCCKGTTC SEQ ID NO: 263 Ro25 DRB17 TGTCATTTCTTCAATGGGAC SEQ ID NO: 264 Fo11 DRB1 AGTGTCATTTCTTCAACGGG SEQ ID NO: 265 Fo12 DRB1 GTGTTATTTCTTCAATGGGA SEQ ID NO: 266 Fo13 DRB1 GTGTCAATTCTTCAATGGGA SEQ ID NO: 267 Fo14 DRB4 Fo GTGTCATTTCCTCAATGGGA SEQ ID NO: 268 DRB1 GGAGCGGGTGCGGTTGCTGG SEQ ID NO: 269 Fi11 DRB1 GGAGCGGGTGCGGTACCTGG SEQ ID NO: 270 Fi12 DRB1 GGAGCGGGTGCGGTTCCTGG SEQ ID NO: 271 Fi13 DRB1 GGAGCGGGTGCGATTCCTGG SEQ ID NO: 272 Fi14 DRB1 GGAGCGGGTGCGGTATCTGC SEQ ID NO: 273 Fi15 DRB1 GGAGCGGGTGCGGTTACTGG SEQ ID NO: 274 Fi16 DRB45 Fi ACATCTATAACCAAGAGGAG SEQ ID NO: 275 DRB6 Fi ACATCCATAAACGGGAGGAG SEQ ID NO: 276 DRB7 Fi TATAACCAAGAGGAGTACGT SEQ ID NO: 277 DRB Ri11 AACCCCGTAGTTGTGTCTGC SEQ ID NO: 278 DRB4 Ri AACCCCGTAGTTGTATCTGC SEQ ID NO: 279 DRB6 Ri CGTAATTGTATCTGCAGTAG SEQ ID NO: 280 DRB7 Ri TAGTTGTCCACTTCGGCCCG SEQ ID NO: 281 DRB Ro1 CGCTGCACTGTGAAGCTCTC SEQ ID NO: 282 DRB Ro2 CGCTGCACCGTGAAGCTCTC SEQ ID NO: 283 DRA Fo CCTGTGGAACTGAGAGAGCC SEQ ID NO: 284 DRA Fi CAACGTCCTCATCTGTTTCA SEQ ID NO: 285 DRA Ri CTGCTGCATTGCTTTTGCGC SEQ ID NO: 286 DRA Ro TTACAGAGGCCCCCTGCGTT SEQ ID NO: 287 DPB Fo GTCCAGGGCAGGGCCACTCC SEQ ID NO: 288 DPB Fi11 AATTACGTGTACCAGGGACG SEQ ID NO: 289 DPB Fi12 AATTACCTTTTCCAGGGACG SEQ ID NO: 290 DPB Fi13 AATTACGTGTACCAGTTACG SEQ ID NO: 291 DPB Fi14 AATTACGCGTACCAGTTACG SEQ ID NO: 292 DPB Ri11 CGGCCTCGTCCAGCTCGTAG SEQ ID NO: 293 DPB Ri12 TGGGCCCGCCCAGCTCGTAG SEQ ID NO: 294 DPB Ri13 TGGGCCCGACCAGCTCGTAG SEQ ID NO: 295 DPB Ro GGACTCGGCGCTGCAGGGTC SEQ ID NO: 296 DPA Fo AGGAGCTGGGGCCATCAAGG SEQ ID NO: 297 DPA Fi GACCATGTGTCAACTTATGC SEQ ID NO: 298 DPA Ri1 CTCAGGGGGATCGTTGGTGG SEQ ID NO: 299 DPA Ri2 CTCAGGGGGATCATTGGCGG SEQ ID NO: 300 DPA Ro CAGCTCCACAGGCTCCTTGG SEQ ID NO: 301 DQB Fo ACTCTCCCGAGGATTTCGTG SEQ ID NO: 302 DQB Fi TGTGCTACTTCACCAACGGG SEQ ID NO: 303 DQB Ri1 ACCTCGTAGTTGTGTCTGCA SEQ ID NO: 304 DQB Ri2 AACTGGTAGTTGTGTCTGCA SEQ ID NO: 305 DQB Ro1 ACTCTCCTCTGCAGGATCCC SEQ ID NO: 306 DQB Ro2 ACTCGCCGCTGCAAGGTCGT SEQ ID NO: 307 DQB Ro3 ACTCTCCTCTGCAAGATCCC SEQ ID NO: 308 DQA Fo TGGTGTAAACTTGTACCAGT SEQ ID NO: 309 DQA Fi ACCCATGAATTTGATGGAGA SEQ ID NO: 310 DQA Ri GGAACCTCATTGGTAGCAGC SEQ ID NO: 311 DQA Ro ACTTGGAAAACACTGTGACC SEQ ID NO: 312 

What is claimed is:
 1. A method for producing an immune status profile for at least one human or animal subject comprising the steps of (a) isolating RNA from the subject's white blood cells, (b) amplifying the RNA using multiplex RT-PCR in a first amplification reaction using nested target-specific forward and reverse primers, the forward primers comprising forward inner and forward outer primers and the reverse primers comprising reverse inner and reverse outer primers, the forward and reverse inner primers comprising additional nucleotides to incorporate into at least one resulting amplicon at least one binding site for at least one common primer, (c) rescuing amplicons from the first amplification reaction, (d) amplifying, by the addition of common primers to a second amplification reaction, the amplicons of the first amplification reaction having at least one binding site for a common primer, and (f) sequencing the amplicons of the second amplification reaction using high-throughput sequencing to identify antibody and/or receptor rearrangements in the cells. 